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Dad aged 91 has been stage 4 CKD for several years, has had an incident of acute kidney failure and a spell of hospitalisation for infections, sepsis, numerous UTIs and now has advanced dementia. He has an Allow a Natural Death Form from consultants.

Have spoken to Care Home and said it would not be in Dad's best interests or family's wishes to extend life as no quality of life and the care home were happy with this but said it would ultimately be the Dr's decision. He now has another UTI- will they treat him with more oral antibiotics dispite these wishes? The hospital discharged him as "medically fit for discharge" a week ago.Am I correct in thinking , if they didn't a UTI might hasten the kidney failure?

A natural death form, I would say, is a roundabout way of saying, 'do not resuscitate' , rather than expressing a wish for a painful death.

On this basis the UTI should be treated, with kidney failure his immune system will depressed, and the volume of fluid drunk will have reduced, this will tend to make him more vulnerable to UTI infections.

Taking more vitamin C may help by making urine more acid, the bacteria involved tend not to like acid conditions.

I thought I would pop back on here and update you that sadly my father away peacefully at Christmas. It didn't prove to be his kidneys in the end , but cause of death given as frailty, old age, and history of stroke/dementia.I'm not looking for sympathy or condolences but I know when I was his carer , thatI was always searching on line for similar stories and comparisons to try and predict what lay ahead so perhaps this will help someone in the future to hear the end of my story. Dad got to the splendid age of 91 , and was probably on stage 4 CKD for at least the last 3 years. Thank you for all the support I have had from this site especially to Wagolynn.